​Designating Shelters

Shelters need to be physically accessible and equipped with the assets and resources necessary to ensure that the needs of individuals with access and functional needs are met in a timely, inclusive and dignified manner. This does not happen unless sheltering plans are developed in close partnership with the whole community.

In addition to ensuring that shelters are accessible and equipped with the proper assets and resources to meet the needs of all survivors; it is critically important to make sure survivors are not separated from their support systems (e.g. care provider, service animal, etc.).

Although a shelter should be able to accommodate all members of the community, it is important to remember that a shelter is not a hotel. For detailed guidance on sheltering, visit the Sheltering section of the AFN Library.

Sheltering Facilities

Facilities designated as shelters should comply with the requirements established under the Americans with Disabilities Act Architecture Guidelines (ADAAG). Locations that do not meet the ADAAG, such as older school buildings and religious establishments, can often be made compliant or useable by obtaining portable units to increase accessibility (e.g. ADA compliant porta potties, showers, etc.) – many such units can be located via the OAFN California Access and Functional Needs Web Map.

In the last few years, many school facilities have been upgraded to meet ADAAG standards and government facilities, such as recreation centers, are often complaint. The decision to open a shelter at a location that violates the ADAAG brings with it significant challenges to appropriately and safely shelter people with access and functional needs.

When identifying shelter locations consider the following:

• Does the area of the facility being utilized for sheltering comply with the ADA Checklist for Emergency Shelters?

• Can the location become useable by obtaining portable units that are accessible?
• When providing evacuation locations, ensure that those locations that are physically accessible are highlighted and clearly stated in press conferences, news broadcasts, press releases, etc.
• Communication access (i.e., sign language interpreters, Braille/Large Print materials, readers, etc.) needs to be available at shelter locations and should be highlighted and clearly stated in press conferences, news broadcasts, press releases, etc.

Sheltering Management Considerations

Overall, individuals with disabilities or access and functional needs should be housed in the general population area of the shelter. When determining the best arrangement for sheltering individuals with disabilities or access and functional needs, it is vital to engage in a dialogue with that person so considerations can be made on an individual basis – as no two persons are the same – and that their preference for assistance be given priority, whenever possible.

Below are some considerations to make when assessing the needs, determining an appropriate destination and planning for sheltering individuals with disabilities or access and functional needs:

• A variety of accessible cots should be available including raised cots, bariatric cots and cots with side rails.
• Some people are non-vocal but still capable of thinking and making their needs known. Shelter staff need to be aware, patient and creative.
• Avoid using outdoor areas that are muddy, sandy, or covered by thick grass.
• Shelter personnel should know how to use the California Relay Service to make and receive phone calls with hearing and speech impaired individuals.
• Permit people with mobility impairments the option of going to the head of long lines.
• Train staff to know how to contact sign language interpreters, independent living centers and mental health providers.
• Train staff about the difference between the medical model and the independence model of disability.
• Train staff not to see individuals with disabilities or access and functional needs as automatically needing medical services.
• Shelters should have information about accessible transportation resources.
• Stock writing tablets and pencils for hearing impaired people to use.

​Medical Sheltering

Description: Individuals have no acute medical conditions, but require medical monitoring, treatment or personal care beyond what is available in general population sheltering.
Examples:

• Non-ambulatory, requiring personal assistance services (no caretaker or assistance available)
• Chronic medical patients unable to self-monitor/medicate
• Requires complete assistance with tube feedings (no caretaker)
• Requires complete assistance with frequent sterile dressing changes for draining wounds (no caretaker or unable to do independently)
• Oxygen dependent requiring respiratory therapy
• Incontinent; requires complete assistance with regular catheterization or bowel care (no caretaker or unable to do independently)
• Terminally ill (with Do Not Resuscitate Papers)

It is recommended that general population shelters include a Support Services Branch, especially when there is a large scale disaster. This branch will provide support to individuals who are medically stable and/or have access and functional needs in addition to those normally provided in a general population shelter. With additional support available, these individuals should be able to remain in the general population shelter. This support may include limited medical and mental health services, along with the provision of durable medical equipment, medications or consumable medical supplies to ensure management of current conditions. The services may be provided by on-site staff or secured through the SEMS process from another source.

Assessments/Services

The California Department of Social Services (CDSS), in collaboration with OAFN, Western University of Health Sciences, the American Red Cross and the California Specialized Training Institute (CSTI) developed a program called the Functional Assessment Service Teams (FAST). FAST provides staff trained to conduct a functional assessment of facilities and survivors with disabilities or access and functional needs as they arrive at shelters. The assessment also evaluates the essential functional needs that can be supported within the general population area of a given shelter. FAST may be deployed as shelters are opened and remain in the shelters until it is determined that they are no longer needed. FAST will transfer to other shelters as needed or requested.

FAST consists of trained government employees and community- based organization (CBO) and non- governmental organizations (NGO) personnel ready to respond and deploy to disaster areas to work in shelters. FAST members must have in-depth knowledge of the populations they serve, their needs, services and resources including housing, benefit programs and disaster aid programs. FAST will work side-by-side with shelter personnel and other emergency response workers to assist in meeting essential functional needs so people can maintain their independence during disasters and emergencies. FAST frees other emergency resources to focus on emergency incidents rather than on mitigating complications.

FAST members have experience in the following areas:

• Older adults (services/supports, including dietary needs)
• Chronic health conditions
• Developmental disabilities
• Other cognitive disabilities (i.e. Traumatic Brain Injury (TBI)
• Hearing loss
• Mental health disabilities
• Physical disabilities
• Vision loss
  

Requests for assistance from the State for FAST occurs through the SEMS/NIMS process and partner agencies will be mission tasked through CDSS and OAFN. It is recommended that local governments establish agreements with organizations in their community to ensure teams can be rapidly deployed to shelters.

For further information on general sheltering visit CA Department of Social Services or Emergency Medical Services Authority for information regarding sheltering individuals with medical needs.

Concept of Operation

Support for essential functional needs will be provided to individuals who have been assessed and determined to be safely accommodated within a shelter. Such accommodations include, but are not limited to, providing assistance in:

• Replacing essential prescribed medications
• Obtaining essential durable medical equipment (DME) and essential consumable medical supplies (CMS).
• Maintaining independence (personal assistance with activities of daily living, older adult non-acute medical and chronic conditions, etc.)
• Providing support to individuals with cognitive limitations
• Providing interpreters and other communication support to assist individuals who require communication assistance (hearing and visual impairments, language/cultural, etc.)
• Providing assistance to individuals who have conditions that affect mobility
• Providing assistance to individuals with chronic but stable respiratory conditions (heart disease, asthma, emphysema, allergies, etc.)
• Providing assistance to individuals with temporary limitations (post-surgery, accident injuries, pregnancy, etc.
• Management and coordination of processes to address the requirements to maintain functional/medical support operations

​Equipment/Resources

It is recommended that private sector provider agreements be established and/or the following equipment/resources be obtained to ensure they are available at general population shelters. Equipment/ resources include but are not limited to:

• Accessible cots-recommended criteria: Height – 17 – 19” (without mattress), width – minimum 27”, weight capacity – 350+ pounds. Flexible head and feet positions. Rails, if any, must be positioned, or moveable, in such a way to allow for wheelchair access. No IV pole
• Toilet chairs
• Raised toilet seats
• Shower chairs
• Wheelchairs (multiple sizes)
• Wheelchair battery chargers
• Walkers
• Walking canes
• White canes for the blind (46”-60”)
• Crutches
• TTY equipment
• Wireless communication devices
• Visual translators (picture, symbols & words)
• Magnifiers
• Hearing aids (batteries)
• Height adjustable tables